engleski

Salmonella induced myocarditis in a 16-year-old boy

Introduction: Myocarditis is uncommon in childhood and adolescence, but the true incidence is difficult to establish given the lack of sufficiently sensitive and specific diagnostic tests and many mild cases of the disease that probably go undetected. It can be caused by both non-infectious and infectious etiologies, but the majority of cases are associated with viral infections. Bacterial myocarditis is rare and usually seen in the context of overwhelming sepsis and/or in immunocompromised hosts. A wide variety of bacterial agents were implicated in its etiology, but non-typhoidal Salmonella (NTS) myocarditis were reported only in a small number of cases. Case presentation: We report a case of previously healty 16-year-old boy with acute myocarditis following Salmonella enteritidis infection. The patient presented to our emergency departement complaining on a recently started chest pain. His other symptoms started 3 days earlier with fever accompanied with profuse diarrhea. At admission, he was well-appearing with low-grade fever and normal vital signs. Laboratory test showed elevated CRP and cardiac biomarkers. Chest x-ray revealed mild cardiomegaly and echocardiography showed reduced ejection fraction with mitral valve prolapse and insufficiency. The diagnosis was confirmed by endomyocardial biopsy. Salmonella enteritidis was isolated from stool cultures, but blood cultures remained negative. Other infectious diseases, drugs and immune disorders were ruled out. Treatment with ACE- inhibitors, spironolactone, ceftriaxone and ibuprofen was initiated. In the following days his gastrointestinal and cardiac symptoms resolved and after 2 weeks he was discharged without complaints. Repeated laboratory test before discharge were normal and ECHO showed normalization of the previous disfunction. Conclusion: NTS infection usually causes diarrheal illness and extraintestinal manifestations are uncommon. In rare circumstances of previously reported Salmonella myocarditis mortality rates were high as well with other bacterial causes of this disease. Due to this fact, Salmonella myocarditis should be suspected in patients presenting with features of myocarditis and gastrointestinal symptoms.

Salmonella ; myocarditis ; children

nije evidentirano